One of the country's leading heart units has been thrown into crisis by internal feuding and poor management, says a report.

Personal animosities at the John Radcliffe Hospital in Oxford have contributed to almost a halving of the number of adult open heart operations carried out there.

The Oxford Heart Centre finds itself on its knees and riven by internal conflict

NHS report

The report from the NHS Executive makes 34 recommendations, and says that unless the problem is dealt with, the centre faces a bleak future.

Health Minister John Denham said: "It is a very worrying report. It paints a
picture of a dysfunctional team and, more than that, a failure to deal with
problems when they were first raised."

The investigation was launched earlier this year following complaints from staff members.

It found serious management failings, lack of leadership, surgeons working in isolation from their peers, alongside severe difficulties in attracting and retaining new staff.

Secrecy and complacency

In addition, it says, there was a culture of secrecy and complacency which meant that steps were not taken to address the problem when it was raised by staff.

It points out: "At a time when cardiac centres throughout the country are gearing up for major expansion called for by the government, the Oxford Heart Centre finds itself on its knees and riven by internal conflict."

The number of operations cancelled on the day of a patient's admission rose by more than a fifth to 130 in the past year.

Staff helping the investigation team spoke of a "drinking club culture" which undermined the management of the centre.

The report recommends that the five cardiothoracic surgeons at the centre must start working as a team - and that except in extreme emergencies, all patients should be seen by a surgeon prior to their operation.

The report also addresses one of the key issues surrounding the death of a two-year old girl during surgery last year.

The heat from the operating theatre lights was said to be so strong that it contributed to the death of Safeena Begum in August 1999.

Her parents are suing the hospital, and the report recommends that the procedure for managing the lights be overhauled.

'Not rocket science'

The author of the report, Stephen Bridge, said: "The 34 recommendations should not surprise the trust - they are not rocket science, they are fundamental building blocks that any NHS hospital should have in place."

The report was welcomed by Barbara Stocking, regional director of the NHS Executive South East.

She said: "The findings give the Oxford Radcliffe Trust board a solid platform from which to tackle the deep-rooted problems identified by the review team."

Royal College of Nursing General Secretary Christine Hancock said: "It is
shameful that it has taken over two years for legitimate concerns about patient
care to be properly investigated.

"The alarm was raised by Colette O'Keefe, a very senior and experienced
clinical nurse at one to the country's top hospitals.

"Despite this, she has had to face extensive bullying and harassment because
she had the courage to speak out."